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Retinopathy of prematurity: age at onset
Insights
Retinopathy of prematurity (ROP) onset is primarily linked to infant developmental stage, not specific neonatal events. This study found ROP appears within a narrow postmenstrual age range, regardless of birth weight or gestational age group.
Area of Science:
- Ophthalmology
- Neonatology
- Developmental Pediatrics
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- The precise timing of ROP onset and its relationship to developmental factors require further elucidation.
Purpose of the Study:
- To determine the age of onset for retinopathy of prematurity (ROP).
- To investigate the influence of gestational age and birth weight on ROP detection timing.
- To ascertain whether developmental stage or neonatal events are primary drivers of ROP onset.
Main Methods:
- Ophthalmological examinations were conducted on 143 infants.
- Infants were categorized by gestational age (<28 weeks vs. ≥28 weeks) and birth weight (<1000 g vs. ≥1000 g).
- Postnatal and postmenstrual ages at the first observation of ROP were recorded and analyzed.
Main Results:
- The median postnatal age for ROP onset differed significantly between gestational age groups (51 days for <28 weeks vs. 40 days for ≥28 weeks).
- Similar significant differences were observed when grouping by birth weight.
- 86% of infants developed ROP between 32.5 and 38.5 weeks postmenstrual age, indicating a narrow onset range.
Conclusions:
- The age of ROP onset is predominantly determined by the infant's developmental stage (postmenstrual age).
- Neonatal events appear to have less influence on the timing of ROP detection compared to developmental maturity.
- ROP detection occurs within a predictable postmenstrual age window, suggesting a maturational timeline for its appearance.
Abstract:
The age at which retinopathy of prematurity was first seen was determined in 143 infants. In all, the initial ophthalmological examination was normal. Birth weights varied from 630 to 2700 g and gestational ages from 24.5 to 40.0 weeks. The median postnatal age at which acute retinopathy of prematurity was first seen was 51 and 40 days for those less than 28 and greater than or equal to 28 weeks' gestational age, respectively, and this difference is highly significant. Similar results were obtained when infants were grouped according to birth weight less than 1000 or greater than or equal to 1000 g. Using postmenstrual age as the variable, the first signs of retinopathy of prematurity were seen over a fairly narrow age range and 86% of infants developed retinopathy between 32.5 and 38.5 weeks of age. These findings suggest that the age (but not the occurrence or severity) at which retinopathy of prematurity is first seen is controlled predominantly by stage of development rather than neonatal events.